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Zhou Q, Yu Q, Wang X, Shi P, Shen Q, Zhang Z, Chen Z, Pu C, Xu L, Hu Z, Ma A, Gong Z, Xu T, Wang P, Wang H, Hao C, Li L, Gao X, Li C, Hao M. Are Essential Women's Healthcare Services Fully Covered? A Comparative Analysis of Policy Documents in Shanghai and New York City from 1978-2017. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:4261. [PMID: 33920527 PMCID: PMC8072775 DOI: 10.3390/ijerph18084261] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 04/09/2021] [Accepted: 04/10/2021] [Indexed: 11/16/2022]
Abstract
This study aimed to analyze the changes in the 10 major categories of women's healthcare services (WHSs) in Shanghai (SH) and New York City (NYC) from 1978 to 2017, and examine the relationship between these changes and maternal mortality ratio (MMR). Content analysis of available public policy documents concerning women's health was conducted. Two indicators were designed to represent the delivery of WHSs: The essential women's healthcare service coverage rate (ESCR) and the assessable essential healthcare service coverage rate (AESCR). Spearman correlation was used to analyze the relationship between the two indicators and MMR. In SH, the ESCR increased from 10% to 90%, AESCR increased from 0% to 90%, and MMR decreased from 24.0/100,000 to 1.01/100,000. In NYC, the ESCR increased from 0% to 80%, the AESCR increased from 0% to 60%, and the MMR decreased from 24.7/100,000 to 21.4/100,000. The MMR significantly decreased as both indicators increased (p < 0.01). Major advances have been made in women's healthcare in both cities, with SH having a better improvement effect. A common shortcoming for both was the lack of menopausal health service provision. The promotion of women's health still needs to receive continuous attention from governments of SH and NYC. The experiences of the two cities showed that placing WHSs among policy priorities is effective in improving service status.
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Affiliation(s)
- Qingyu Zhou
- Research Institute of Health Development Strategies, Fudan University, Shanghai 200032, China; (Q.Z.); (Q.Y.); (X.W.); (L.L.); (X.G.)
- Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai 200032, China; (P.S.); (Q.S.); (Z.Z.); (Z.C.); (C.P.); (L.X.); (Z.H.); (A.M.); (Z.G.); (T.X.); (P.W.); (H.W.); (C.H.)
- Department of Health Policy and Management, School of Public Health, Fudan University, Shanghai 200032, China
| | - Qinwen Yu
- Research Institute of Health Development Strategies, Fudan University, Shanghai 200032, China; (Q.Z.); (Q.Y.); (X.W.); (L.L.); (X.G.)
- Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai 200032, China; (P.S.); (Q.S.); (Z.Z.); (Z.C.); (C.P.); (L.X.); (Z.H.); (A.M.); (Z.G.); (T.X.); (P.W.); (H.W.); (C.H.)
- Department of Health Policy and Management, School of Public Health, Fudan University, Shanghai 200032, China
| | - Xin Wang
- Research Institute of Health Development Strategies, Fudan University, Shanghai 200032, China; (Q.Z.); (Q.Y.); (X.W.); (L.L.); (X.G.)
- Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai 200032, China; (P.S.); (Q.S.); (Z.Z.); (Z.C.); (C.P.); (L.X.); (Z.H.); (A.M.); (Z.G.); (T.X.); (P.W.); (H.W.); (C.H.)
- Department of Health Policy and Management, School of Public Health, Fudan University, Shanghai 200032, China
| | - Peiwu Shi
- Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai 200032, China; (P.S.); (Q.S.); (Z.Z.); (Z.C.); (C.P.); (L.X.); (Z.H.); (A.M.); (Z.G.); (T.X.); (P.W.); (H.W.); (C.H.)
- Zhejiang Academy of Medical Sciences, Hangzhou 310012, China
| | - Qunhong Shen
- Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai 200032, China; (P.S.); (Q.S.); (Z.Z.); (Z.C.); (C.P.); (L.X.); (Z.H.); (A.M.); (Z.G.); (T.X.); (P.W.); (H.W.); (C.H.)
- School of Public Policy and Management, Tsinghua University, Beijing 100084, China
| | - Zhaoyang Zhang
- Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai 200032, China; (P.S.); (Q.S.); (Z.Z.); (Z.C.); (C.P.); (L.X.); (Z.H.); (A.M.); (Z.G.); (T.X.); (P.W.); (H.W.); (C.H.)
- Project Supervision Center of National Health Commission of the People’s Republic of China, Beijing 100044, China
| | - Zheng Chen
- Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai 200032, China; (P.S.); (Q.S.); (Z.Z.); (Z.C.); (C.P.); (L.X.); (Z.H.); (A.M.); (Z.G.); (T.X.); (P.W.); (H.W.); (C.H.)
- Department of Grassroots Public Health Management Group, Public Health Management Branch of Chinese Preventive Medicine Association, Shanghai 201800, China
| | - Chuan Pu
- Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai 200032, China; (P.S.); (Q.S.); (Z.Z.); (Z.C.); (C.P.); (L.X.); (Z.H.); (A.M.); (Z.G.); (T.X.); (P.W.); (H.W.); (C.H.)
- School of Public Health and Management, Chongqing Medical University, Chongqing 400016, China
| | - Lingzhong Xu
- Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai 200032, China; (P.S.); (Q.S.); (Z.Z.); (Z.C.); (C.P.); (L.X.); (Z.H.); (A.M.); (Z.G.); (T.X.); (P.W.); (H.W.); (C.H.)
- School of Public Health, Shandong University, Jinan 250012, China
| | - Zhi Hu
- Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai 200032, China; (P.S.); (Q.S.); (Z.Z.); (Z.C.); (C.P.); (L.X.); (Z.H.); (A.M.); (Z.G.); (T.X.); (P.W.); (H.W.); (C.H.)
- School of Health Service Management, Anhui Medical University, Hefei 230032, China
| | - Anning Ma
- Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai 200032, China; (P.S.); (Q.S.); (Z.Z.); (Z.C.); (C.P.); (L.X.); (Z.H.); (A.M.); (Z.G.); (T.X.); (P.W.); (H.W.); (C.H.)
- School of Management, Weifang Medical University, Weifang 261053, China
| | - Zhaohui Gong
- Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai 200032, China; (P.S.); (Q.S.); (Z.Z.); (Z.C.); (C.P.); (L.X.); (Z.H.); (A.M.); (Z.G.); (T.X.); (P.W.); (H.W.); (C.H.)
- Committee on Medicine and Health of Central Committee of China Zhi Gong Party, Beijing 100011, China
| | - Tianqiang Xu
- Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai 200032, China; (P.S.); (Q.S.); (Z.Z.); (Z.C.); (C.P.); (L.X.); (Z.H.); (A.M.); (Z.G.); (T.X.); (P.W.); (H.W.); (C.H.)
- Institute of Inspection and Supervision, Shanghai Municipal Health Commission, Shanghai 200031, China
| | - Panshi Wang
- Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai 200032, China; (P.S.); (Q.S.); (Z.Z.); (Z.C.); (C.P.); (L.X.); (Z.H.); (A.M.); (Z.G.); (T.X.); (P.W.); (H.W.); (C.H.)
- Shanghai Municipal Health Commission, Shanghai 200031, China
| | - Hua Wang
- Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai 200032, China; (P.S.); (Q.S.); (Z.Z.); (Z.C.); (C.P.); (L.X.); (Z.H.); (A.M.); (Z.G.); (T.X.); (P.W.); (H.W.); (C.H.)
- Jiangsu Preventive Medicine Association, Nanjing 210009, China
| | - Chao Hao
- Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai 200032, China; (P.S.); (Q.S.); (Z.Z.); (Z.C.); (C.P.); (L.X.); (Z.H.); (A.M.); (Z.G.); (T.X.); (P.W.); (H.W.); (C.H.)
- Changzhou Center for Disease Control and Prevention, Changzhou 213003, China
| | - Li Li
- Research Institute of Health Development Strategies, Fudan University, Shanghai 200032, China; (Q.Z.); (Q.Y.); (X.W.); (L.L.); (X.G.)
- Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai 200032, China; (P.S.); (Q.S.); (Z.Z.); (Z.C.); (C.P.); (L.X.); (Z.H.); (A.M.); (Z.G.); (T.X.); (P.W.); (H.W.); (C.H.)
- Department of Health Policy and Management, School of Public Health, Fudan University, Shanghai 200032, China
| | - Xiang Gao
- Research Institute of Health Development Strategies, Fudan University, Shanghai 200032, China; (Q.Z.); (Q.Y.); (X.W.); (L.L.); (X.G.)
- Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai 200032, China; (P.S.); (Q.S.); (Z.Z.); (Z.C.); (C.P.); (L.X.); (Z.H.); (A.M.); (Z.G.); (T.X.); (P.W.); (H.W.); (C.H.)
- Department of Health Policy and Management, School of Public Health, Fudan University, Shanghai 200032, China
| | - Chengyue Li
- Research Institute of Health Development Strategies, Fudan University, Shanghai 200032, China; (Q.Z.); (Q.Y.); (X.W.); (L.L.); (X.G.)
- Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai 200032, China; (P.S.); (Q.S.); (Z.Z.); (Z.C.); (C.P.); (L.X.); (Z.H.); (A.M.); (Z.G.); (T.X.); (P.W.); (H.W.); (C.H.)
- Department of Health Policy and Management, School of Public Health, Fudan University, Shanghai 200032, China
| | - Mo Hao
- Research Institute of Health Development Strategies, Fudan University, Shanghai 200032, China; (Q.Z.); (Q.Y.); (X.W.); (L.L.); (X.G.)
- Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai 200032, China; (P.S.); (Q.S.); (Z.Z.); (Z.C.); (C.P.); (L.X.); (Z.H.); (A.M.); (Z.G.); (T.X.); (P.W.); (H.W.); (C.H.)
- Department of Health Policy and Management, School of Public Health, Fudan University, Shanghai 200032, China
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Bradford VA, Walkinshaw LP, Steinman L, Otten JJ, Fisher K, Ellings A, O'Leary J, Johnson DB. Creating Environments to Support Breastfeeding: The Challenges and Facilitators of Policy Development in Hospitals, Clinics, Early Care and Education, and Worksites. Matern Child Health J 2018; 21:2188-2198. [PMID: 28707098 DOI: 10.1007/s10995-017-2338-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Objectives Supportive organizational breastfeeding policies can establish enabling environments for breastfeeding. In this qualitative study we identify facilitators and barriers to the development, adoption, and implementation of supportive breastfeeding policies and practices in four influential sectors for breastfeeding women: hospitals, clinics, early care and education settings, and worksites. Methods We interviewed 125 individuals representing 110 organizations in Washington State about their breastfeeding policy development and implementation process between August 2014 and February 2015. Greenhalgh's diffusion of innovations framework guided the interviews and qualitative analysis. Results Breastfeeding policy facilitators across the sectors include national and state laws and regulations, performance tracking requirements, and an increasingly supportive sociopolitical climate; barriers include limited resources and appreciation about the need for breastfeeding policies, and certain organizational characteristics such as workforce age. Despite broad support for breastfeeding, organizations differed on perceptions about the usefulness of written breastfeeding policies. Personal breastfeeding experiences of policy makers and staff affect organizational breastfeeding policies and practices. Conclusions for Practice Supportive organizational systems and environments are built through effective policy development processes; public health can support breastfeeding policy development and assure a coordinated continuum of care by leveraging federal health care policy requirements, building networks to support training and collaboration, and disseminating strategies that reflect the personal nature of breastfeeding.
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Affiliation(s)
- Victoria A Bradford
- Center for Public Health Nutrition, University of Washington, Box 353410, 305 Raitt, Seattle, WA, 98195, USA.
| | - Lina P Walkinshaw
- Center for Public Health Nutrition, University of Washington, Box 353410, 305 Raitt, Seattle, WA, 98195, USA
| | - Lesley Steinman
- Center for Public Health Nutrition, University of Washington, Box 353410, 305 Raitt, Seattle, WA, 98195, USA
| | - Jennifer J Otten
- Center for Public Health Nutrition, University of Washington, Box 353410, 305 Raitt, Seattle, WA, 98195, USA
| | - Kari Fisher
- Multnomah County Health Department, 5329 NE Martin Luther King Jr Blvd, Portland, OR, 97211, USA
| | - Amy Ellings
- Washington State Department of Health, 310 Israel Rd SE, Tumwater, WA, 98501, USA
| | - Jean O'Leary
- Washington State Department of Health, 310 Israel Rd SE, Tumwater, WA, 98501, USA
| | - Donna B Johnson
- Center for Public Health Nutrition, University of Washington, Box 353410, 305 Raitt, Seattle, WA, 98195, USA
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